Braunschweig Richard, Baur Audrey Sylvia, Delacrétaz Françoise, Bricod Charlotte, Benhattar Jean
University Institute of Pathology, University Hospital Vaudois, Lausanne, Switzerland.
Am J Clin Pathol. 2003 May;119(5):634-42. doi: 10.1309/NPQX-QV82-Q0R8-VBKT.
We investigated whether the determination of clonality by polymerase chain reaction (PCR) analysis of immunoglobulin heavy chain (IgH) gene rearrangements could be helpful in the evaluation of B-cell lymphoma (BCL) involvement of bone marrow (BM) biopsy specimens. We evaluated 83 paraffin-embedded BM biopsy specimens from 26 patients with BCL. When BM biopsy specimens considered positive, "suspicious," or negative by morphologic and immunohistochemical examination were evaluated by PCR, a monoclonal B-cell population was detected in 81% (39/48), 64% (9/14), and 11% (2/18), respectively. In most cases, a reproducible monoclonal IgH gene rearrangement was observed from BM and extramedullary sites. Nevertheless, in 4 cases, a different and independent monoclonal IgH rearrangement was observed during the disease course. PCR is efficient and complementary to morphologic and immunohistochemical examination for the evaluation of BCL involvement of BM biopsy specimens, especially when a reproducible rearrangement is found in 2 different samples.
我们研究了通过免疫球蛋白重链（IgH）基因重排的聚合酶链反应（PCR）分析来确定克隆性是否有助于评估骨髓（BM）活检标本中的B细胞淋巴瘤（BCL）累及情况。我们评估了来自26例BCL患者的83份石蜡包埋的BM活检标本。当通过形态学和免疫组织化学检查被认为阳性、“可疑”或阴性的BM活检标本进行PCR评估时，分别在81%（39/48）、64%（9/14）和11%（2/18）中检测到单克隆B细胞群体。在大多数情况下，从BM和髓外部位观察到可重复的单克隆IgH基因重排。然而，在4例病例中，在疾病过程中观察到不同且独立的单克隆IgH重排。PCR对于评估BM活检标本中的BCL累及情况是有效且是形态学和免疫组织化学检查的补充，特别是当在2个不同样本中发现可重复的重排时。
